Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease

Abstract Background Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is a key drug for ALK rearranged lung adenocarcinoma. Interstitial lung disease (ILD) is an important adverse effect of alectinib, which generally requires termination of treatment. However, we treated two...

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Main Authors: Tatsuya Nitawaki, Yoshihiko Sakata, Kodai Kawamura, Kazuya Ichikado
Format: Article
Language:English
Published: BMC 2017-12-01
Series:BMC Pulmonary Medicine
Subjects:
ALK
GGO
Online Access:http://link.springer.com/article/10.1186/s12890-017-0519-y
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spelling doaj-191e4ad0b98b4f37a6378b2ea25167b02020-11-24T21:45:10ZengBMCBMC Pulmonary Medicine1471-24662017-12-011711410.1186/s12890-017-0519-yCase report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung diseaseTatsuya Nitawaki0Yoshihiko Sakata1Kodai Kawamura2Kazuya Ichikado3Division of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalDivision of Respiratory Medicine, Saiseikai Kumamoto HospitalAbstract Background Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is a key drug for ALK rearranged lung adenocarcinoma. Interstitial lung disease (ILD) is an important adverse effect of alectinib, which generally requires termination of treatment. However, we treated two patients with drug-induced ILD who continued to receive alectinib. Case presentation Patient 1 was a 57-year-old male with an ALK-rearranged Stage IV lung adenocarcinoma who was administered alectinib as first-line therapy. Computed tomography (CT) detected asymptomatic ground-glass opacity (GGO) on day 33 of treatment. Alectinib therapy was therefore discontinued for 7 days and then restarted. GGO disappeared, and the progression of ILD ceased. Patient 2 was a 64-year-old woman with an ALK-positive lung adenocarcinoma who was administered alectinib as third-line therapy. One year later, CT detected GGO; and she had a slight, nonproductive cough. Alectinib therapy was continued in the absence of other symptoms, and GGO slightly diminished after 7 days. Two months later, CT detected increased GGO, and alectinib therapy was continued. GGO diminished again after 7 days. The patient has taken alectinib for more than 2 years without progression of ILD. Conclusions Certain patients with alectinib-induced ILD Grade 2 or less may continue alectinib therapy if they are closely managed.http://link.springer.com/article/10.1186/s12890-017-0519-yLung cancerNon-small cell lung cancerALKAlectinibInterstitial lung diseaseGGO
collection DOAJ
language English
format Article
sources DOAJ
author Tatsuya Nitawaki
Yoshihiko Sakata
Kodai Kawamura
Kazuya Ichikado
spellingShingle Tatsuya Nitawaki
Yoshihiko Sakata
Kodai Kawamura
Kazuya Ichikado
Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
BMC Pulmonary Medicine
Lung cancer
Non-small cell lung cancer
ALK
Alectinib
Interstitial lung disease
GGO
author_facet Tatsuya Nitawaki
Yoshihiko Sakata
Kodai Kawamura
Kazuya Ichikado
author_sort Tatsuya Nitawaki
title Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
title_short Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
title_full Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
title_fullStr Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
title_full_unstemmed Case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
title_sort case report: continued treatment with alectinib is possible for patients with lung adenocarcinoma with drug-induced interstitial lung disease
publisher BMC
series BMC Pulmonary Medicine
issn 1471-2466
publishDate 2017-12-01
description Abstract Background Alectinib, a second-generation anaplastic lymphoma kinase (ALK) inhibitor, is a key drug for ALK rearranged lung adenocarcinoma. Interstitial lung disease (ILD) is an important adverse effect of alectinib, which generally requires termination of treatment. However, we treated two patients with drug-induced ILD who continued to receive alectinib. Case presentation Patient 1 was a 57-year-old male with an ALK-rearranged Stage IV lung adenocarcinoma who was administered alectinib as first-line therapy. Computed tomography (CT) detected asymptomatic ground-glass opacity (GGO) on day 33 of treatment. Alectinib therapy was therefore discontinued for 7 days and then restarted. GGO disappeared, and the progression of ILD ceased. Patient 2 was a 64-year-old woman with an ALK-positive lung adenocarcinoma who was administered alectinib as third-line therapy. One year later, CT detected GGO; and she had a slight, nonproductive cough. Alectinib therapy was continued in the absence of other symptoms, and GGO slightly diminished after 7 days. Two months later, CT detected increased GGO, and alectinib therapy was continued. GGO diminished again after 7 days. The patient has taken alectinib for more than 2 years without progression of ILD. Conclusions Certain patients with alectinib-induced ILD Grade 2 or less may continue alectinib therapy if they are closely managed.
topic Lung cancer
Non-small cell lung cancer
ALK
Alectinib
Interstitial lung disease
GGO
url http://link.springer.com/article/10.1186/s12890-017-0519-y
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